Which factors raise mortality risk in neonates CRAB sepsis?

In neonates with carbapenem-resistant Acinetobacter baumannii (CRAB) sepsis, factors such as congenital heart disease, clinical risk index for babies (CRIB) II score ≥9, shock, and severe thrombocytopaenia are associated with the risk of death, reveals a recent study.

A team of investigators performed a retrospective medical records review to identify the risk factors of mortality in neonates with CRAB sepsis, including both bacteraemia and meningitis, in Thailand from 1996 to 2019. They reviewed all cases featuring positive blood and cerebrospinal fluid cultures for CRAB. Multivariable logistic regression was conducted for survivors and nonsurvivors of neonatal CRAB sepsis.

Forty-seven cases of CRAB sepsis were identified over a 24-year period. The median gestational age and birth weight of patients were 30 weeks and 1,500 g, respectively. The 30-day case fatality rate was 55 percent (26 out of 47).

Multivariable analysis revealed that congenital heart disease (adjusted odds ratio [aOR], 1.33, 95 percent confidence interval [CI], 1.06–1.66; p=0.02), CRIB II score ≥9 (aOR, 1.65, 95 percent CI, 1.20–2.27; p=0.004), severe thrombocytopaenia (aOR, 1.45, 95 percent CI, 1.09–1.94; p =0.02), and septic shock (aOR, 1.62, 95 percent CI, 1.33–1.99; p<0.001) were significantly associated with mortality from neonatal CRAB sepsis.

“CRAB sepsis is becoming an extreme threat caused by high-case fatality rates and poor prevention and control in intensive care units worldwide,” the investigators said.